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Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.

Materials and methods

We sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.

Results

A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.

Conclusions

The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.

OBJECTIVES/SPECIFIC AIMS: To create a searchable public registry of all Quality Improvement (QI) projects. To incentivize the medical professionals at UF Health to initiate quality improvement projects by reducing startup burden and providing a path to publishing results. To reduce the review effort performed by the internal review board on projects that are quality improvement Versus research. To foster publication of completed quality improvement projects. To assist the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety in managing quality improvement across the hospital system. METHODS/STUDY POPULATION: This project used a variant of the spiral software development model and principles from the ADDIE instructional design process for the creation of a registry that is web based. To understand the current registration process and management of quality projects in the UF Health system a needs assessment was performed with the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety to gather project requirements. Biweekly meetings were held between the Quality Improvement office and the Clinical and Translational Science – Informatics and Technology teams during the entire project. Our primary goal was to collect just enough information to answer the basic questions of who is doing which QI project, what department are they from, what are the most basic details about the type of project and who is involved. We also wanted to create incentive in the user group to try to find an existing project to join or to commit the details of their proposed new project to a data registry for others to find to reduce the amount of duplicate QI projects. We created a series of design templates for further customization and feature discovery. We then proceed with the development of the registry using a Python web development framework called Django, which is a technology that powers Pinterest and the Washington Post Web sites. The application is broken down into 2 main components (i) data input, where information is collected from clinical staff, Nurses, Pharmacists, Residents, and Doctors on what quality improvement projects they intend to complete and (ii) project registry, where completed or “registered” projects can be viewed and searched publicly. The registry consists of a quality investigator profile that lists contact information, expertise, and areas of interest. A dashboard allows for the creation and review of quality improvement projects. A search function enables certain quality project details to be publicly accessible to encourage collaboration. We developed the Registry Matching Algorithm which is based on the Jaccard similarity coefficient that uses quality project features to find similar quality projects. The algorithm allows for quality investigators to find existing or previous quality improvement projects to encourage collaboration and to reduce repeat projects. We also developed the QIPR Approver Algorithm that guides the investigator through a series of questions that allows an appropriate quality project to get approved to start without the need for human intervention. RESULTS/ANTICIPATED RESULTS: A product of this project is an open source software package that is freely available on GitHub for distribution to other health systems under the Apache 2.0 open source license. Adoption of the Quality Improvement Project Registry and promotion of it to the intended audience are important factors for the success of this registry. Thanks goes to the UW-Madison and their QI/Program Evaluation Self-Certification Tool (https://uwmadison.co1.qualtrics.com/SE/?SID=SV_3lVeNuKe8FhKc73) used as example and inspiration for this project. DISCUSSION/SIGNIFICANCE OF IMPACT: This registry was created to help understand the impact of improved management of quality projects in a hospital system. The ultimate result will be to reduce time to approve quality improvement projects, increase collaboration across the UF Health Hospital system, reduce redundancy of quality improvement projects and translate more projects into publications.

The government publishes 3 different public report surgical site infection (SSI) metrics, all called standardized infection ratios (SIRs), that impact perceived hospital quality. We conducted a non-random cross-sectional observational pilot study of 20 California hospitals that voluntarily submitted colon surgery and SSI data. Discordant SIR values, leading to contradictory conclusions, occurred in 35% of these hospitals.

Activists try to use high profile trials to advance their political agendas, and we want to understand why they occasionally succeed in promoting policy reforms. We begin by reviewing literature on agenda setting and social problem construction, conceptualising high profile trials as “focusing events” that offer activists a chance to advance their definitions and remedies for particular social problems. We next outline the feminist movement against sexual violence as a useful example of activists trying to use trials for their own political purposes. Using events data from the New York Times and the secondary treatment of 13 high profile trials from 1960 to 1997, we examine factors that help or hinder activists’ efforts to use a trial to forward their cause. We see that both the nature of the trial and the political context surrounding it affect the likelihood that a movement gains control of its meaning and secures policy reform.

More than 50% of the global population already lives in urban settlements and urban areas are projected to absorb almost all the global population growth to 2050, amounting to some additional three billion people. Over the next decades the increase in rural population in many developing countries will be overshadowed by population flows to cities. Rural populations globally are expected to peak at a level of 3.5 billion people by around 2020 and decline thereafter, albeit with heterogeneous regional trends. This adds urgency in addressing rural energy access, but our common future will be predominantly urban. Most of urban growth will continue to occur in small-to medium-sized urban centers. Growth in these smaller cities poses serious policy challenges, especially in the developing world. In small cities, data and information to guide policy are largely absent, local resources to tackle development challenges are limited, and governance and institutional capacities are weak, requiring serious efforts in capacity building, novel applications of remote sensing, information, and decision support techniques, and new institutional partnerships. While ‘megacities’ with more than 10 million inhabitants have distinctive challenges, their contribution to global urban growth will remain comparatively small.

Energy-wise, the world is already predominantly urban. This assessment estimates that between 60–80% of final energy use globally is urban, with a central estimate of 75%. Applying national energy (or GHG inventory) reporting formats to the urban scale and to urban administrative boundaries is often referred to as a ‘production’ accounting approach and underlies the above GEA estimate.

Protecting and promoting human rights has been a historical give and take. Activists at the grass roots have worked courageously to expose violations of human rights, attempting to enlist more powerful authorities to pressure or punish violators. They have used the tools of social movements, including protests and demonstrations, in attempts to mobilize an audience into action. A wide range of institutions, including national institutions, as well as supranational bodies and transnational organizations, have articulated universalistic standards of human rights and publicized the work of activists, calling for states to protect human rights. Nothing happens easily, as effective enforcement of human rights generally involves more powerful actors intervening to alter the balance of power within a state. Both activists and authorities seek to move beyond ad hoc enforcement of human rights, establishing a permanent presence to keep human rights in view. What are we to make of the establishment of new institutions at the national level specifically charged with the protection of human rights? How do these national human rights institutions (NHRIs) influence the ongoing campaigns to advance the cause?

The chapters in this volume emphasize the limitations of NHRIs. It is difficult to get states to create institutions that are independent enough and sufficiently powerful to provide meaningful redress, particularly when the national bodies that create human rights institutions are often also culpable in the violation of human rights. Even institutions that comply with ideal organizational structures (in theory) suffer from political interference, inadequate funding, and leadership failures. Indeed, the intense attention to the need for exceptional leadership undermines the notion that establishing NHRIs can, in itself, address ongoing concerns about human rights.

Ion irradiation induced grain growth size distributions in Pd are examined at low temperatures. Two features are observed: 1) A majority of the grains saturate in size. 2) Some grains achieve sizes much larger than the average grain size and continue to grow with ion dose. However, by careful choice of ion mass and ion dose, it is possible to produce a sample possessing a monomodal grain size. This process will have applications in producing thin films of nanocrystalline materials.

The science of extra-solar planets is one of the most rapidly changing areas of astrophysics and since 1995 the number of planets known has increased by almost two orders of magnitude. A combination of ground-based surveys and dedicated space missions has resulted in 560-plus planets being detected, and over 1200 that await confirmation. NASA's Kepler mission has opened up the possibility of discovering Earth-like planets in the habitable zone around some of the 100,000 stars it is surveying during its 3 to 4-year lifetime. The new ESA's Gaia mission is expected to discover thousands of new planets around stars within 200 parsecs of the Sun. The key challenge now is moving on from discovery, important though that remains, to characterisation: what are these planets actually like, and why are they as they are?

In the past ten years, we have learned how to obtain the first spectra of exoplanets using transit transmission and emission spectroscopy. With the high stability of Spitzer, Hubble, and large ground-based telescopes the spectra of bright close-in massive planets can be obtained and species like water vapour, methane, carbon monoxide and dioxide have been detected. With transit science came the first tangible remote sensing of these planetary bodies and so one can start to extrapolate from what has been learnt from Solar System probes to what one might plan to learn about their faraway siblings. As we learn more about the atmospheres, surfaces and near-surfaces of these remote bodies, we will begin to build up a clearer picture of their construction, history and suitability for life.

The Exoplanet Characterisation Observatory, EChO, will be the first dedicated mission to investigate the physics and chemistry of Exoplanetary Atmospheres. By characterising spectroscopically more bodies in different environments we will take detailed planetology out of the Solar System and into the Galaxy as a whole.

EChO has now been selected by the European Space Agency to be assessed as one of four M3 mission candidates.

The watershed Supreme Court decision in Brown v. Board of
Education affected activist politics on issues that extend well
beyond African-American civil rights or education. The apparent success of
the Court decision in spurring social change encouraged activists in other
social movements to emulate the NAACP Legal Defense Fund's litigation
strategy, and to adapt organizational structures, political strategies,
and rhetoric borrowed from the civil rights movement. We examine how a
Supreme Court decision and its subsequent interpretation influenced the
development of other social movements. Borrowing from work on social
movements, we contend that the Court decision signaled judicial openness
to stand up for minority points of view on questions of fundamental
rights, and that the civil rights movement spilled over to affect other
movements. Activists continued to respond to that signal decades after
Brown, even when that signal of judicial responsiveness and
openness did not reflect the real prospects for achieving influence
through a litigation-based strategy.David
S. Meyer is Professor of Sociology and Political Science (dmeyer@uci.edu)
and Steven A. Boutcher is Doctoral Candidate (sboutche@uci.edu) in
Sociology, University of California, Irvine. We are grateful for helpful
comments on an earlier draft of this paper from Lisa Garcia Bedolla,
Catherine Corrigall-Brown, Stephanie DiAlto, Sharon Lean, Sharon Oselin,
and Su Yang.

Maybe a president or Congressional leader will, upon reading a report by the American Academy of Arts and Sciences or hearing a plea from the leader of another country or even glancing at this book, become convinced of the need to take substantial action to address the dangers of global warming. Once convinced, this leader would build broad political coalitions with other political figures based on reasoned appreciation of a real environmental problem, and devise a comprehensive set of policy reforms to reduce America's key role in promoting global warming. Within a few years, the United States would develop and implement a range of policies to reduce the concentration of CO2 in the atmosphere, including dedicated taxes, regulatory reforms, and large-scale initiatives in renewable energy and energy conservation.

This could happen, but that's not the way major changes in American history have taken place before. Reasoned discourse needs a push. Elected officials, even presidents, are subject to an ever-expanding range of pressures and constraints, making substantial policy reform in any area exceedingly difficult. Further, the American Constitution established a governmental structure built to produce stability rather than innovation, solidity rather than responsiveness – in effect, a Humvee rather than a hybrid of government. But substantial, if sometimes unwelcome, innovations in policy have taken place in America, including (among others) the institution of a federal social safety net for the elderly in the 1930s, the establishment of a permanent and globally engaged military establishment in the 1940s, federal intervention in the cause of civil rights and women's rights in the 1950s and 1960s, and a broad retrenchment in government support for the less fortunate, commenced in the 1970s.

As part of its mission to address issues of recruitment, retention,
and integration of women and people of color in the profession, the APSA
Task Force on Mentoring periodically publishes articles on some aspect of
mentoring that will help political scientists move successfully through
the profession. This brief symposium on “Publishing Your First
Book” is just one such example of this initiative. For more
information about the Task Force and its ongoing projects, contact Linda
Lopez, APSA Director of Education and Professional Development Programs,
at llopez@apsanet.org.

Making a realistic assessment of your goals in publishing a book, and
matching a publisher with the text and with your goals is the first step
in bringing your research effort to completion. Social scientists write
books hoping to influence an election, change the political debate, shift
an academic focus, get tenure, or get a job. A good book, well-published,
can help achieve some of these goals—but there are other
ways to work toward them. Authors and publishers will be happiest, and
readers best served, if authors take stock of the possible, and then
market their books to publishers who are best suited to help with the
goals they've chosen. Beyond writing the book, the author has three
clear tasks: deciding on realistic goals for the book; executing due
diligence in finding the right publishing house; and making the gist of
the book accessible to an educated, but not necessarily expert, reader by
writing a good proposal. Matching expectations to the book will help
identify the most appropriate presses.